DEP/DUA/1/42/07 (Normalised version)

Betty Culbert

(1787-1788)

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N^o7. Betty Culbert. at 15.

Symptoms which occur in this patients case, such as take place in many different affections.

And cannot be said to constitute any particular disease.

And am I own at some loss with regard to real nature of affection.

Has however arrived at that period of life when menstrual [usually] commences.

And symptoms here taking place what often attendant of amenorrhea.

Well known however that same symptoms often arise from want of natural discharge as are consequence of obstruction.

And too this some reason to [presume] that present symptoms to be ascribed.

Am I own disposed to view it as an example of Amenorrhea.

And of that modification which styled Amenorrhea emansionis.

At same time must be allowed that menses often wanting from condition of system.

And that here want of discharge in place of cause of affection may be merely symptom.

Must also admit, that patient has merely arrived to period of common appearance.

And that in many instances much later without any uneasiness.

Hence may be altogether unconnected with state of discharge.

And at least must be allowed that no regular or periodic aggravation of symptoms.

From all these considerations then the induction of menstrual flux not only objective to be had in view.

At same time even allowing that want of discharge neither cause nor consequence of symptoms yet highly probable that appearance would make considerable change on nature of affection.

And am in hopes that by occurring under our care, present symptoms may entirely disappear.

While at same time not improbable that this event may take place although no menstrual for considerable time to come.

And upon whole hopes as to termination of this case rather favourable than otherwise.

In cure endeavour naturally employed, to counteract such symptoms as at the time most urgent.

To endeavour to restore general health & vigour to system.

And finally to give such determination of blood to uterine vessels, as may at least forward natural tendency to discharge.

Is with this view that have directed a mixture with aromatic & bitters conjoined.

And that had recourse to employment of aloetic pills.

Of latter however operation so brisk that have been obliged to desist from employment.

While pains so urgent as to lead to topical application.

But of these shall afterwards [speak] more fully when treat of case at greater length.